Charts of the 23 POMS patients at Texas Children’s Hospital treated with rituximab were reviewed. We excluded patients without follow up imaging at least 6 months after starting rituximab.

Annualized relapse rate (ARR) before and after initiation of rituximab and presence of new T2 or contrast-enhancing lesions on MRI at least 6 months after initiation were determined for the remaining 17 patients.

NEDA was defined as absence of new T2 or contrast-enhancing lesions on MRI, absence of increased post-treatment disability by 1.0 on the Expanded Disability Status Scale (EDSS), and absence of relapses. 

Mean age of patients was 18 years (13-22 years). Mean disease duration was 41 months (9-108 months). Four patients received rituximab as their first disease-modifying treatment (DMT), 9 patients due to disease progression on other DMTs and 4 patients due to side effects related to other DMTs.

Sixteen of the seventeen patients have had no clinical relapses while on rituximab with a mean of 21 months on therapy (9-46 months). One patient had optic neuritis (ON).

On follow-up MRI, 14 patients had no new lesions. 2 patients had 1 new T2 lesion on MRI 6 months post loading doses. The patient with ON had evidence of contrast-enhancement in the affected optic nerve.

EDSS remained stable for all patients (mean 0.5) while on rituximab.

Eighty-two percent (14 of 17) of patients fulfilled criteria for NEDA-3.